Utilization Management Coordinator
Key Responsibilities
- Process incoming faxes and manage prior authorization requests.
- Create, update, and maintain utilization management authorizations.
- Review UM cases and ensure accurate documentation.
- Handle provider phone calls in a fast-paced call center environment.
- Collaborate with internal teams to support authorization and care management workflows.
Required Skills & Qualifications
- 3+ years of Utilization Management experience in a healthcare payer or managed care environment.
- Call center experience is required.
- Working knowledge of CPT, ICD, and HCPCS coding.
- GuidingCare experience is strongly preferred (top priority).
- Experience with Facets and NiceXone is a plus.
Company Description
Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, and Enterprise Transformation.
Pay
The pay for this position is commensurate with experience.
Schedule
The schedule for this role is 3 months contract with possible extension.
Benefits
Lumen Solutions Group Inc. offers a competitive benefits package including health insurance, retirement plans, and paid time off.
Qualifications
None specified.
Skills
None specified.
Benefits
None specified.
Pay
The pay for this position is commensurate with experience.
Schedule
The schedule for this role is 3 months contract with possible extension.
Application Instructions
None provided.